New trends in health care delivery affect facility design

Trends in the design and construction of health care and research facilities are dictated by the economy and pending legislation, as much as by innovations in the medical field.

Many health care providers are opting for renovations of existing facilities instead of launching new construction projects. Medical-related facilities must remain state-of-the-art, so a lot of the changes being made to current buildings are often connected with technology.

Picture the new wave in operating rooms. Hybrid ORs contain an MRI machine so the surgeon can take images during a procedure to check on the patient’s condition.

Ben Johanneman, project director in the Houston division of McCarthy Building Companies Inc., said his firm is designing a few hybrid operating rooms.

“They’re not that common,” he said. “Most hospitals don’t have them right now.”

Operating rooms may also feature what’s known as a “wall of knowledge” — a series of flat screens on the wall that display the patient’s vital signs and other data so it is readily available during the procedure.

The high-tech nature of health care also requires contractors to pay more attention to technology needs during the construction process. McCarthy now hires audio/visual and information technology specialists for those projects.

“We hire these specialty consultants that we never hired before,” Johanneman said.

MRI technology advances so quick that architects and contractors have to take that into account before, during and after construction.

Rooms with MRI equipment are often built out last by contractors so the absolute latest technology can be installed. MRI machines become outdated every three to six years, which means contractors have to design a way to get the large, heavy equipment out of the building when it’s time to replace it.

It used to be that MRIs would be replaced every 10 years, but now it’s every six years or so, said Mike Simpson, a principal with Houston-based Vaughn Construction LLC.

“The time periods between the switch-outs are faster,” he said.

DESIGNING BETTER HEALTH CARE

The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital gets a lot of attention for the way it looks on the outside. The 13-story building in the Texas Medical Center has twisting concrete double helix columns representing the DNA strand. But what’s going on behind the façade is of note, as well.

The building, which has six labs and two more on the way, was designed to use less energy to clean the air in the labs, said Jason Chan, senior project manager on the building and senior associate in Houston with the Perkins+Will architecture firm.

A lot of energy is spent bringing clean air into labs and exhausting the old air, Chan explained. Labs typically undergo 10 to 12 air changes an hour. But, Chan said, studies show that 98 percent of the time the exhausted air is clean. Frequent air changes are needed only when there has been a spill or contamination, he said.

The innovative building is using demand-control ventilation to reduce the number of air changes per hour to six if the air is already clean, he said.

Only a couple other Houston labs utilize the energy-saving measure, but this is the largest installation of its type in Texas, Chan said.

“It’s a type of system people are starting to implement now,” he said.

Another upcoming trend in the design of research facilities involves translational health care, which bringsmedical researchers physically closer to the patients they are trying to help, said Maurice Robison, managing principal in Houston for HDR Architecture.

The University of Texas M.D. Anderson Cancer Center, a leader in translational health care, is spreading the word about its benefits to other medical providers, Robison said.

If the practice becomes more widespread, it could mean changes in hospital design where testing facilities are placed closer to patient-care areas, he said.

And the trend of hospitals hiring physicians as employees will likely cause a shift in the way medical office buildings are developed, said Walt Mischer Jr., president of Mischer Healthcare Services LP.

“The facilities are not as populated with individual practitioners as they used to be,” Mischer said. “The facilities being built are for group practices.”